January 13, 2014
One reason invasive treatments for back pain have been rising in recent years, Deyo says, is the ready availability of MRI scans. These detailed, color-coded pictures that can show a cross-section of the spine are a technological tour de force. But they can be dangerously misleading.
“Seeing is believing,” Deyo says. “And gosh! We can actually see degenerated discs, we can see bulging discs. We can see all kinds of things that are alarming.”
That is, they look alarming. But they’re most likely not the cause of the pain.
Lots of people who are pain-free actually have terrible-looking MRIs.
Research is showing that the pain often has nothing to do with the mechanics of the spine, but with the way the nervous system is behaving, according to Dr. James Rainville of New England Baptist Hospital in Boston.
“It’s a change in the way the sensory system is processing information,” says Rainville, who is a physiatrist, or specialist in rehabilitation medicine. “Normal sensations of touch, sensations produced by movements, are translated by the nervous system into a pain message. That process is what drives people completely crazy who have back pain, because so many things produce discomfort.”
Overtreating Chronic Back Pain: Time to Back Off?
J Am Board Fam Med January-February 2009, 22 (1): 62-68
Richard A. Deyo